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NQC e-Newsletter |  Your expert guide to resources and technical assistance focusing on improving HIV care.




This month features an article on how grantees can work together to improve their quality improvement efforts. NQC has learned that groups of peers working together towards common goals are a powerful force for improvement. Participants of the Training on Coaching Basics (TCB) Program formed such peer groups to allow for sharing of individual challenges and successes and to provide peer support for each other. NQC would like to explore options offering other grantees the opportunity to form such groups for the purpose of peer learning. This is an exciting opportunity to expend your QI knowledge and develop your own peer network.


Hopefully, you are all enjoying your summer.



Clemens Steinbock

Director, National Quality Center



> In This Issue

> NQC News | August 15 | National TA Call | Change Fatigue
> NQC News | New HIVQUAL Brief Announced - Using Mortality Rates to Improve Care
> NQC News | in+care Campaign Update
> Real World Quality | Sindy Paul, MD, MPH
> Consumer Perspective | Dennis Creedon
> NQC Consultant Spotlight | Kathy Reims, MD
> NQC Offering | Job Forum
> Highlights from the NQC Collection | Change Fatigue

> NQC News | Study Groups Energize Quality Improvement Efforts  


The National Quality Center (NQC) has facilitated many HAB-sponsored learning collaboratives over its existence. One of the lessons learned from these learning activities is how effective peer groups of committed HIV providers can be in maintaining the momentum of quality improvement efforts. For a long time, we have stressed the fact that teams perform better than individuals. In our face-to-face trainings, group work is often done in breakout groups. The work product of these breakout groups has always been impressive and so many participants comment on how helpful it is to work with peers. Most recently, we applied the concept of a study group in our training program. The NQC Training in Coaching Basics Program has a six-month post-work schedule for study groups that reinforces the lessons of the training and also builds on itself to develop new ideas and directions in quality improvement. These study groups are formed during the face-to-face training with the charge to have monthly communications, mostly via conference calls, and to discuss their study group assignments. Study group participants have enjoyed the engagement with their peers to discuss common issues and to jointly address challenges on their quality journey. Many study groups have stayed actively connected well beyond the six month mark.


NQC can assist you in developing your own quality improvement study group. We have many graduates of our face-to-face trainings who have expressed an interest in developing similar groups and also in acting as team leaders. To find out how to begin contact Kevin Garrett at Kevin@NationalQualityCenter.org

> NQC News | New HIVQUAL Brief Announced - Using Mortality Rates to Improve Care


Mortality rates are one of the most commonly used outcome measures to judge the effectiveness of care, but knowing their limitations is key for understanding their relevance to the quality of care provided in a health care organization or by specific providers. HIVQUAL Brief 9 highlights work performed at the University of Colorado-Denver and University Hospitals of Cleveland - two Ryan White funded providers - to demonstrate the potential for small teams to improve quality management activities by tracking and examining population mortality rates. Both programs have utilized their data and findings to implement system changes with the goal of improving patient outcomes.


Download the brief  l  click here

> NQC News | in+care Campaign Update


This summer, the in+care Campaign is working hard to provide Ryan White providers with resources to make an impact on keeping people living with HIV engaged in medical care. The month of August will focus on how to improve retention among transitory populations (e.g. migrant workers). September will focus on issues specific to women and retention in HIV care. October will focus on retention in care for individuals engaged in the exchange of sex, food, shelter, money and/or drugs.


Have you visited the in+care Campaign website lately? There have been big changes. Materials and resources in Events, Resources, Campaign Tools, and Strategies sections have been reorganized to make our resources easier to identify and locate.


In the coming months, please let us know about your retention in care improvement stories. The in+care Campaign is compiling slide decks of 'Lightning Rounds,' which are simple 1-2 slide presentations to catalogue the course of specific improvement strategies and interventions. For more information on how to produce Lightning Rounds slide presentations and where to find the presentations already collected, contact Michael Hager at Michael@NationalQualityCenter.org.


Learn more about the in+care Campaign | www.incarecampaign.org

Real World Quality  Sindy Paul, MD, MPH 


New Jersey and quality improvement go hand-in-hand. Sindy Paul, MD, Medical Director for the Part B grant has long been focused on using performance measures to evaluate the quality of HIV care being provided by Part B providers. Before the HIV/AIDS Bureau (HAB) measures were introduced, Dr. Paul and her team looked at their performance data and set yearly priorities on which to focus.


New Jersey was one of five states to take part in NQC's Cross-Part Collaborative, which was launched in October 2008. As part of the Collaborative, each participating state was expected to adopt key HAB Clinical Performance Measures as well as additional measures appropriate to their individual programs. Participation in the Collaborative provided an opportunity to create alignment across programs within a state and foster the use of data to improve health outcomes. Dr. Paul along with Jane Caruso - who is now an NQC Coach - led the cross-Part team for New Jersey and their efforts produced impressive results.


Thanks to Dr. Paul's efforts, New Jersey's Part B program has a Steering Committee that examines changing trends in data and makes improvement recommendations, provides educational opportunities for Committee members as well as other interested parties, helps subgrantees develop their own quality management plans, and has also developed a multi-media educational campaign.


To ensure that subgrantees have the tools necessary to implement their quality management program the state provides extensive training opportunities for health professionals. CME courses on performance measurement have been developed. These educational efforts are designed to reach a wide range of providers but also take into consideration various learning modalities.


"We are working one-on-one with NQC to expand the use of performance measures beyond core services to support services," says Dr. Sindy Paul. NQC consultant Dan Sendzik, assigned to New Jersey, is assisting with the development of these new measures. Dan also participates in QM Steering Committee meetings and helped to plan the statewide technical assistance conference.

> Consumer Perspective | Dennis Creedon


It's never too late to learn more. Dennis Creedon has been a part-time client advocate at the University of Oklahoma Health Sciences Center Infectious Diseases Institute (IDI) since 2007, where he serves as the main liaison between consumers and staff. He also has served on the IDI's continuous quality improvement (CQI) Committee since 2008 and facilitates the client advisory board. This summer, he attended NQC's Training of Consumers on Quality (TCQ) in Sacramento-his first encounter with the NQC.


"I came away with a better understanding of the various types of measurement, such as qualitative and quantitative methods, and concepts such as numeracy," says Dennis. "I was able to build on my existing knowledge."


In addition to building knowledge, the TQC session is designed to build the skills that allow consumers to participate effectively in quality-related activities especially the quality committee.


"I learned that leadership can come from anyone at any level in an organization - you don't have to have multiple degrees or be an administrator," says Dennis. "Anyone can change the paradigm in an organization."


"The training empowers and challenges people," he adds. "Over the course of the training, I saw people increase their confidence and become more involved. It was very gratifying to see someone who was hanging back at the beginning take the lead in an exercise and speak for the group."


Since the TCQ session, Dennis has been working to retool IDI's process for consumer input. The first step is a Town Hall meeting for consumers and other stakeholders that will take place this month. Based on the feedback received during the Town Hall, Dennis will revamp the consumer input process. He already has a group of consumers who are committed to participating.


In addition, Dennis has become involved in the Partners in+care Campaign, which is part of the in+care Campaign. Partners in+care connects consumers via social media and other methods with the goal of promoting retention in care. It looks like Dennis is on his way to a long-term relationship with NQC.

> NQC e-Newsletter | Volume 7 | Issue 62 | Aug 2013 


Quick Links


> Upcoming Events | August

August 1 | in+care data submission due


August 6, 2013 at 2pm ET | in+care Campaign Journal Club | NYC Care Coordination Program and Patient Navigation


August 8, 2013 at 2pm ET | in+care Campaign Webinar | Patient Navigation in its Many Forms


August 15 | National TA Call | Change Fatigue 

> NQC Consultant Spotlight | Kathy Reims, MD


Kathy Reims, MD is new to NQC, joining the NQC's coaching team in 2012. She is focused on providing technical assistance to individual grantees in the Midwest including those in Missouri, Kansas and Southern Illinois,  
and supports the Midwestern Regional Group that also welcomes participation from grantees in these states and Arkansas. While Kathy is new to NQC, she brings a long experience of direct patient care for safety net populations, community health center leadership, as well as diverse experience in quality improvement and practice transformation. She has led quality initiatives at multiple levels from hands-on guidance within an organization to initiatives with a national focus. HIV-specific quality improvement activities have included coaching of Part A, B, and C grantees, facilitation of state-wide QI plans, and an advisory role for quality improvement
programs in British Columbia and Uganda.


Kathy received her Doctorate in Medicine from Baylor College of Medicine in Houston Texas and completed her family medicine residency in Roanoke, Virginia. She is an Assistant Clinical Professor in the Department of Family Medicine for the University of Colorado Health Sciences Center and works with the residency track based in the Lowry Family Health Center, a community clinic that is part of the Denver Health system. Kathy has particular interests in system-level improvement and patient engagement.

> NQC Offering | Job Forum


What good are all NQC's great resources if your organization doesn't have anyone to use them? To help Ryan White grantees fill their quality-related job vacancies, NQC established the Job Forum. On the Forum, Ryan White Program grantees can post quality improvement-related vacancies. In addition, NQC maintains sample quality improvement job descriptions from grantees.

If you have a vacancy, please post your job description. If you are looking for a job, be sure to check out the Job Forum regularly.

Visit the Job Forum | click here

> Highlights from the NQC Collection | Change Fatigue

In today's health care environment, the rapid pace of change can result in resistance. Staff often push back when they are constantly asked to do something different. How organizations implement change can have a significant impact on whether staff accept, or even embrace, the changes. NQC has a variety of resources designed to help organizations handle change in a productive and supportive manner.


National TA Call: Change Fatigue

August 15, 3:00-4:30 pm ET

Register |  click here


As part of our newly expanded National Technical Assistance (TA) Calls, NQC is now suggesting that grantees review these resources before the upcoming TA Call. These resources will help you to frame questions for our presenters and enhance your learning experience.


Previous Technical Assistance Calls:

Gaining Agency and Subcontractor Buy-in for Quality Management, November 2010


Engaging Provider Staff and Consumers in Quality Improvement, September/October 2007



Quality Academy Tutorial 16: Managing Resistance to Change and Holding Gains

This NQC Quality Academy Tutorial deals with the topic of resistance to change. It examines why people resist change and outlines some general approaches to help organizations make changes more easily. Specific strategies to use when your organization encounters direct resistance to new ideas are provided.


National Quality Center

New York State Department of Health

AIDS Institute

90 Church Street, 13th floor

New York, NY 10007-2919

Phone | 212.417.4730

Fax | 212.417.4684

Email | Info@NationalQualityCenter.org 


Sharing, Training, Consulting.

Improving HIV Care.

> About Us


We provide no-cost, state-of-the-art technical assistance to all Ryan White Program-funded grantees to improve the quality of HIV care nationwide.  


Send questions, comments, or suggestions | Info@NationalQualityCenter.org  


This e-Newsletter is produced by the National Quality Center, a quality improvement initiative funded through a cooperative agreement with the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau. For more information | NationalQualityCenter.org  


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